Since the early 1990's, the death rate from
AIDS among adults has declined in most developed countries, largely because of newer antiretroviral
therapies and improved access to these
therapies. In addition, from 2006 to 2011, the total number of new cases of
HIV infection worldwide has declined somewhat and has remained relatively constant. Nevertheless, because of the large numbers of existing and new cases of
HIV infection, the dental practitioner and other healthcare practitioners will still be required to treat oral and periodontal conditions unique to HIV/
AIDS as well as conventional
periodontal diseases in HIV-infected adults and children. The oral and periodontal conditions most closely associated with
HIV infection include
oral candidiasis,
oral hairy leukoplakia,
Kaposi's sarcoma,
salivary gland diseases, oral
warts, other oral
viral infections, linear gingival
erythema and necrotizing gingival and
periodontal diseases. While the incidence and prevalence of these oral lesions and conditions appear to be declining, in part because of antiretroviral
therapy, dental and healthcare practitioners will need to continue to diagnose and treat the more conventional
periodontal diseases in these HIV-infected populations. Finding low-cost and easily accessible and acceptable diagnostic and treatment approaches for both the microbiological and the inflammatory aspects of
periodontal diseases in these populations are of particular importance, as the systemic spread of the local microbiota and inflammatory products of
periodontal diseases may have adverse effects on both the progression of
HIV infection and the effectiveness of antiretroviral
therapy approaches. Developing and assessing low-cost and accessible diagnostic and treatment approaches to
periodontal diseases, particularly in developing countries, will require an internationally coordinated effort to design and conduct standardized clinical trials.